Powered bipolar resectoscope

ABSTRACT

A resectoscope includes a fixed electrode adapted to connect to a first electrical potential, a movable electrode adapted to connect to a second electrical potential and biased transversely towards the fixed electrode, and a spacer coupled to the movable electrode. The movable electrode and the spacer are longitudinally movable relative to the fixed electrode between a first position, wherein the spacer is disposed between the fixed electrode and the movable electrode so as to maintain a spacing between the movable electrode and the fixed electrode against the bias of the movable electrode, and a second position, wherein the spacer is disposed distally of the fixed electrode, allowing the movable electrode to move transversely towards the fixed electrode under the bias of the movable electrode.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 62/211,102, filed on Aug. 28, 2015, theentire contents of which are incorporated herein by reference.

BACKGROUND

Technical Field

The present disclosure relates to instruments for surgically resectingtissue and, more particularly, to a powered bipolar resectoscope for usein resecting tissue during prostate, intrauterine, and other surgicalprocedures.

Background of Related Art

A resectoscope is typically utilized during the course of a surgicalprocedure, e.g., a prostate or intrauterine surgical procedure, forremoving tissue. Conventional resectoscopes include a handle, anendoscope extending from the handle, and one or more electrodesextending distally from the endoscope. The handle is provided forallowing the surgeon to manipulate e.g., extend and retract, the one ormore electrodes relative to the endoscope. The endoscope enables thesurgeon to view the surgical site. The one or more electrodes areconfigured to be energized and advanced through tissue to electricallyresect tissue. The one or more electrodes may define a bipolarconfiguration or a monopolar configuration.

SUMMARY

As used herein, the term “distal” refers to the portion that is beingdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, to the extent consistent, any of the aspects described hereinmay be used in conjunction with any or all of the other aspectsdescribed herein.

In accordance with aspects of the present disclosure, a resectoscope isprovided including an end effector assembly. The end effector assemblyincludes a fixed electrode, a movable electrode, and a spacer. The fixedelectrode is adapted to connect to a first electrical potential andextends in a longitudinal direction. The movable electrode is adapted toconnect to a second electrical potential and is biased transverselytowards the fixed electrode. The spacer is coupled to the movableelectrode. The movable electrode and the spacer are longitudinallymovable relative to the fixed electrode between a first position,wherein the spacer is disposed between the fixed electrode and themovable electrode so as to maintain a spacing between the movableelectrode and the fixed electrode against the bias of the movableelectrode, and a second position, wherein the spacer is disposeddistally of the fixed electrode, allowing the movable electrode to movetransversely towards the fixed electrode under the bias of the movableelectrode.

In an aspect of the present disclosure, the movable electrode includes apair of longitudinal sections disposed within a plane and a U-shapedsection. The U-shaped section interconnects the distal ends of thelongitudinal sections and extends transversely relative to the plane ofthe longitudinal sections. The longitudinal sections are resilientlybiased towards the fixed electrode, thereby biasing the movableelectrode transversely towards the fixed electrode.

In another aspect of the present disclosure, the longitudinal sectionsare spaced-apart from one another and disposed on either side of thefixed electrode. In the second position of the movable electrode and thespacer, the longitudinal sections extend transversely beyond the fixedelectrode on either side thereof.

In yet another aspect of the present disclosure, the end effectorassembly further includes a longitudinally-extending shaft and a carrierengaging a proximal end of the movable electrode with thelongitudinally-extending shaft such that movement of thelongitudinally-extending shaft relative to the fixed electrode between aproximal position and a distal position moves the movable electrode andthe spacer between the first and second positions.

In still another aspect of the present disclosure, an endoscope defininga field of view is disposed on the fixed electrode. In such aspects, thefixed electrode may further include an illumination assembly configuredto illuminate the field of view of the endoscope.

In still yet another aspect of the present disclosure, thelongitudinally-extending shaft defines a channel having an open distalend that is configured to receive resected tissue upon movement of themovable electrode and the spacer from the first position to the secondposition.

In another aspect of the present disclosure, the U-shaped section of themovable electrode is aligned with the longitudinally-extending shaft inthe first position of the movable electrode, and is offset transverselyrelative to the longitudinally-extending shaft in the second position ofthe movable electrode.

In still another aspect of the present disclosure, the resectoscopefurther includes a drive assembly operably coupled to thelongitudinally-extending shaft and a motor coupled to the driveassembly. The motor is configured to drive the drive assembly to movethe longitudinally-extending shaft between a proximal position and adistal position.

In yet another aspect of the present disclosure, the drive assemblyincludes a lead screw defining a helical track and a collar disposedabout the lead screw and operably coupled to the helical track such thatrotation of the lead screw translates the collar about the lead screw.The motor is configured to rotate the lead screw to translate the collarabout the lead screw, thereby moving the longitudinally-extending shaftbetween the proximal position and the distal position.

In still yet another aspect of the present disclosure, the helical trackis continuous and wherein the motor is configured to drive rotation ofthe lead screw in a single direction to translate the collar about thelead screw from a proximal end of the lead screw to a distal end of thelead screw and back to the proximal end of the lead screw.

Another resectoscope provided in accordance with aspects of the presentdisclosure includes a housing, a drive assembly, a shaft, a movableelectrode, and a fixed electrode. The drive assembly is disposed withinthe housing and includes a lead screw defining a helical track. A collarof the drive assembly is disposed about the lead screw and operablycoupled to the helical track such that rotation of the lead screwtranslates the collar about the lead screw. The shaft is coupled to thecollar and extends distally from the housing. Translation of the collarabout the lead screw translates the shaft relative to the housingbetween a proximal position and a distal position. The fixed electrodeis adapted to connect to a first electrical potential, is fixed relativeto the housing, and extends distally from the housing alongside theshaft. The movable electrode is adapted to connect to a secondelectrical potential and is coupled to the shaft such that translationof the shaft relative to the housing between the proximal position andthe distal position moves the movable electrode relative to the fixedelectrode between a first position and a second position.

In an aspect of the present disclosure, a motor is disposed within thehousing and configured to drive rotation of the lead screw.

In another aspect of the present disclosure, the helical track iscontinuous and the motor is configured to drive rotation of the leadscrew in a single direction to translate the collar about the lead screwfrom a proximal end of the lead screw to a distal end of the lead screwand back to the proximal end of the lead screw.

In still another aspect of the present disclosure, the resectoscopefurther includes a sheath assembly. The sheath assembly includes aproximal base releasably engagable with the housing and an elongatedsheath configured to at least partially surround the shaft, movableelectrode, and fixed electrode.

In yet another aspect of the present disclosure, the proximal base ofthe sheath assembly includes a port adapted to connect to at least oneof a source of suction or a source of irrigation for applying suction orirrigation, respectively, through the elongated sheath.

In still yet another aspect of the present disclosure, the movableelectrode is movable longitudinally along the fixed electrode from thefirst position to an intermediate position and is movable bothlongitudinally and transversely relative to the fixed electrode from theintermediate position to the second position.

In another aspect of the present disclosure, the movable electrode isstationary relative to the shaft during movement of the movableelectrode from the first position to the intermediate position and ismovable transversely relative to the shaft during movement of themovable electrode from the intermediate position to the second position.

In yet another aspect of the present disclosure, the resectoscopefurther includes a carrier engaging the movable electrode with theshaft.

In another aspect of the present disclosure, an endoscope defining afield of view that extends at least partially between the fixedelectrode and the shaft is provided.

In still another aspect of the present disclosure, the movable electrodeincludes a pair of longitudinal sections disposed within a plane and aU-shaped section. The U-shaped section interconnects distal ends of thelongitudinal sections and extends transversely relative to the plane ofthe longitudinal sections.

In still yet another aspect of the present disclosure, in the firstposition of the movable electrode, the U-shaped section is aligned withthe shaft. In the second position of the movable electrode, the U-shapedsection is offset transversely relative to the shaft.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects and features of the present disclosure are describedherein with reference to the drawings wherein:

FIG. 1 is a perspective view of a resectoscope provided in accordancewith the present disclosure;

FIG. 2 is a perspective view of a sheath assembly of the resectoscope ofFIG. 1;

FIG. 3 is a perspective view of the resectoscope of FIG. 1 with thesheath assembly removed therefrom;

FIG. 4 is a side view of the proximal end of the resectoscope of FIG. 1with a portion of the housing removed to illustrate the internalcomponents thereof;

FIG. 5A is a perspective view of the distal end of the resectoscope ofFIG. 1, disposed in a first position;

FIG. 5B is a side view of the distal end of the resectoscope of FIG. 1,disposed in the first position;

FIG. 5C is a distal end view of the distal end of the resectoscope ofFIG. 1, disposed in the first position;

FIG. 6A is a side, perspective view of the distal end of theresectoscope of FIG. 1, disposed in a second position;

FIG. 6B is a side view of the distal end of the resectoscope of FIG. 1,disposed in the second position;

FIG. 6C is a distal end view of the distal end of the resectoscope ofFIG. 1, disposed in the second position;

FIG. 7 is a top, perspective view of the distal end of the resectoscopeof FIG. 1, disposed in the second position; and

FIG. 8 is a schematic illustration of a robotic surgical systemconfigured for use in conjunction with aspects and features of thepresent disclosure.

DETAILED DESCRIPTION

Referring to FIGS. 1-4, provided in accordance with the presentdisclosure is a resectoscope identified by reference numeral 10.Resectoscope 10 generally includes a housing 100, an end effectorassembly 200 extending distally from housing 100, a sheath assembly 300releasably engagable with housing 100 and configured for positioningabout at least a portion of end effector assembly 200, and a cableassembly 400. As detailed below, resectoscope 10 is configured as abipolar electrosurgical resection and removal apparatus for use inprostate, intrauterine, and/or other surgical procedures, althoughresectoscope 10 may alternatively be configured for use with monopolarenergy or other forms of energy, e.g., light energy, thermal energy,ultrasonic energy, etc.

Housing 100 includes a body portion 102 and a distal nose 104 disposedat the distal end of body portion 102. Body portion 102 of housing 100encloses the internal operable components of resectoscope 10, asdetailed below, and includes a guide 106 defined on the exterior surfacethereof. Guide 106 includes a channel 108 defined within the exteriorsurface of body portion 102 and a clip 110 having first and second arms111 a, 111 b disposed on either side of channel 108 and extendingoutwardly from the exterior surface of body portion 102. Guide 106 isconfigured to releasably secure a fluid line (not shown) therein tomaintain the fluid line (not shown) in position extending along housing100. Such a configuration inhibits the fluid line (not shown) frombecoming tangled and/or interfering with the manipulation and operationof resectoscope 10.

Distal nose 104 of housing 100 includes a distal ring 112 having a pairof opposed posts 114 extending inwardly therefrom. Distal ring 112 andposts 114 are configured to facilitate releasable engagement of sheathassembly 300 with housing 100. More specifically, proximal base 310 ofsheath assembly 300 defines a cylindrical portion 312 having a diameterslightly less than that of distal ring 112 of distal nose 104 of housing100 to enable insertion of cylindrical portion 312 of proximal base 310of sheath assembly 300 at least partially into distal ring 112 of distalnose 104 of housing 100. Cylindrical portion 312 further defines a pairof opposed L-shaped slots 314 configured to receive posts 114 of distalring 112 upon insertion of cylindrical portion 312 of proximal base 310into distal ring 112. Once inserted in this manner, proximal base 310 ofsheath assembly 300 may be rotated relative to distal ring 112 of distalnose 104 of housing 100 to couple sheath assembly 300 with housing 100via a bayonet-style engagement. Alternatively, other suitable releasableengagements may be provided, e.g., snap-fit, friction-fit, threadedcoupling, etc.

Referring to FIG. 2, sheath assembly 300, as mentioned above, includesproximal base 310 including a cylindrical portion 312 configured toreleasably engage distal nose 104 of housing 100. Proximal base 310further includes a conical portion 316 extending distally fromcylindrical portion 312. An elongated tubular sheath 320 extendsdistally from conical portion 316 of proximal base 310. As detailedbelow, elongated tubular sheath 320 is configured to slidably receiveshaft 220 and movable electrode 230 of end effector assembly 200 (FIG.3). Sheath assembly 300 further includes a valve assembly 330 includinga port 332 that selectively communicates with the interior of proximalbase 310 and elongated tubular sheath 320, and a knob 334 associatedwith an internal valve (not shown) to enable a user to manuallytransition valve assembly 330 between an open condition, wherein port332 communicates with the interior of proximal base 310 and elongatedtubular sheath 320 to permit fluid flow therebetween, and a closedcondition, wherein fluid flow through port 332 is inhibited. Port 332may be configured to receive a fluid line (not shown), e.g., viafriction-fit engagement about port 332, for applying irrigation and/oraspiration through elongated tubular sheath 320. As noted above, thefluid line (not shown) may be releasably secured within guide 106 ofhousing (FIG. 1) to inhibit tangling or interference.

With reference to FIG. 4, housing 100 encloses an interior cavity 116configured to house a drive assembly 120 and operably support theproximal end of end effector assembly 200. Drive assembly 120 includes amotor 122, a lead screw 124, a collar 126, and a pin 128. Motor 122 isoperably coupled to lead screw 124 and configured to drive rotation oflead screw 124. Lead screw 124 defines a helical track 130 extendingalong at least a portion of the length thereof. Collar 126 is slidablydisposed about lead screw 124. Pin 128 includes a first end that iscoupled to collar 126 and a second end that is operably disposed withinhelical track 130 defined within lead screw 124 such that, uponrotational driving of lead screw 124 via motor 122, pin 128 is movedthrough helical track 130 to thereby translate collar 126 about leadscrew 124 and relative to housing 100. Collar 126 of drive assembly 120further includes a foot 132 that extends therefrom, as detailed below.

Lead screw 124 may be configured as a continuous lead screw 124 suchthat motor 122 need only drive lead screw 124 in a single direction. Insuch a configuration, once collar 126 has been translated to the distalend of helical track 130, further driving of motor 122 in the samedirection returns collar 126 proximally back towards the proximal end ofhelical track 130. Likewise, once collar 126 has been translated to theproximal end of helical track 130, further driving of motor 122 in thesame direction returns collar 126 distally back towards the distal endof helical track 130. Alternatively, where lead screw 124 is not acontinuous lead screw 124, motor 122 may be configured to operate in aforward mode, wherein lead screw 124 is driven to rotate in a firstdirection to urge collar 126 to translate distally about lead screw 124and relative to housing 100, and a reverse mode, wherein lead screw 124is driven to rotate in a second, opposite direction to urge collar 126to translate proximally about lead screw 124 and relative to housing100.

An actuator (not shown) may be mounted on the exterior of housing 100and coupled to motor 122 to enable selective activation of motor 122.With regard to configurations including a forward and reverse-drivemotor 122, the actuator may be configured as a rocker switch, forexample, to enable selective activation of motor 122 in each of theforward and reverse modes. With regard to configurations including asingle-direction drive motor 122, the actuator may be a push-buttonswitch. Other suitable actuators, either on housing 100 or remotetherefrom, may alternatively be provided.

Referring to FIGS. 1, 3, and 4-7, end effector assembly 200 includes aplank 210, a shaft 220, a movable electrode 230, and a carrier assembly240. Plank 210 is formed from, coated with, or otherwise includes anelectrically-conductive material disposed thereon and/or therein toallow plank 210 to serve as the fixed electrode of end effector assembly200. Plank 210 defines a proximal end that is fixedly engaged withinhousing 100 and extends distally from housing 100 through elongatedtubular sheath 320 of sheath assembly 300 (when sheath assembly 300 isengaged with housing 100). An exposed distal portion 212 of plank 210extends distally from sheath assembly 300. An elongated cut-out 214defined transversely through distal portion 212 of plank 210 isconfigured to receive an LED assembly 216 (FIG. 7), e.g., a longitudinalarray of LED's mounted within a casing, to illuminate the area betweendistal portion 212 of plank 210 and shaft 220, as detailed below.Alternatively, the LED assembly 216 (FIG. 7) may be mounted underneathplank 210 or in any other suitable position with or without a cut-out214 defined within plank 210. In some embodiments, plank 210 may definea generally rectangular cross-sectional configuration, with the distalend thereof inducing a rounded lip 218. As detailed below, rounded lip218 defines a guide surface configured to guide movement of movableelectrode 230 relative to plank 210.

Plank 210 further includes endoscope 250 engaged therewith and dependingthereform. Endoscope 250 is oriented in a distal-facing direction andmay be angled relative to shaft 220 so as to define a field of viewencompassing the area surrounding U-shaped loop section 236 of movableelectrode 230, the area disposed between the distal ends of plank 210and shaft 220, and/or the area distally adjacent shaft 220. Endoscope250 is configured to obtain video and/or still images of its field ofview for output to an external display monitor, thus enabling a surgeonto visualize the tissue resection process, as detailed below. LEDassembly 216 (FIG. 7) is operably positioned relative to endoscope 250to illuminate the field of view of endoscope 250 to facilitatevisualization thereof.

Shaft 220 of end effector assembly 200 defines a proximal end disposedwithin housing 100. Shaft 220 extends distally from housing 100 throughelongated tubular sheath 320 of sheath assembly 300 (when sheathassembly 300 is engaged with housing 100). The proximal end of shaft 220is engaged with foot 132 of collar 126 of drive assembly 120. As aresult of this configuration, translation of collar 126 about lead screw124 and relative to housing 100, e.g., via the rotational driving oflead screw 124 imparted thereto via motor 122, likewise translates foot132 and, thus, shaft 220 relative to housing 100 and sheath assembly300. More specifically, shaft 220 is translatable relative to housing100 and sheath assembly 300 between a proximal position, wherein thedistal end of shaft 220 is disposed within or protrudes a first distancefrom the distal end of elongated tubular sheath 320, and a distalposition, wherein the distal end of shaft 220 extends distally from thedistal end of elongated tubular sheath 320 a second, larger distance. Asdetailed below, movable electrode 230 and carrier assembly 240 aremovable in conjunction with shaft 220 and relative to plank 210 andelongated tubular sheath 320 between a retracted position of endeffector assembly 200 (FIGS. 5A-5C), corresponding to the proximalposition of shaft 220, and an extended position of end effector assembly200 (FIGS. 6A-7), corresponding to the distal position of shaft 220.

Shaft 220 defines an open distal end, a U-shaped cross-sectionalconfiguration, and a channel 224 extending longitudinally therethrough.Channel 224 communicates with an elongated mouth 226 that extendslongitudinally along at least a portion of shaft 220. Shaft 220 isoriented to extend along plank 210 such that elongated mouth 226 ofchannel 224 opposes the bottom surface of plank 210. Elongated mouth 226is defined between a pair of longitudinal shelves 228 of shaft 220 thatextend along at least a portion of the length of shaft 220. Shelves 228narrow elongated mouth 226 such that elongated mouth 226 defines a widththat is less than a width of channel 224. Via channel 224, suction maybe applied through shaft 220 from the proximal end thereof to enable thewithdrawal of fluids and/or resected tissue.

With reference to FIGS. 5A-7, movable electrode 230 is formed from oneor more electrically-conductive wire segments and includes a pair ofspaced-apart longitudinal sections 232, 234 interconnected at theirdistal ends by a U-shaped loop section 236. U-shaped loop section 236extends transversely relative to longitudinal sections 232, 234 and, insome embodiments, may extend orthogonally relative to longitudinalsections 232, 234. Longitudinal sections 232, 234 are spaced-apart adistance greater than the width of plank 210, thus enabling plank 210 topass therebetween, as detailed below. Longitudinal sections 232, 234 areformed from a resilient material and are biased towards an at-restposition, wherein longitudinal sections 232, 234 are angled upwardlysuch that the distal portions thereof extend above plank 210 and atleast portion of U-shaped loop section 236 extends above plank 210, asdetailed below.

A spacer 238 is disposed about the distal ends of longitudinal sections232, 234 of movable electrode 230 adjacent U-shaped loop section 236. Inthe retracted position of end effector assembly 200 and during movementof end effector assembly 200 from the retracted position towards theextended position, spacer 238 is configured to maintain the distal endof movable electrode 230 in spaced-apart relation relative to plank 210,against the bias of resilient longitudinal sections 232, 234. Morespecifically, spacer 238 defines a cut-out 239 that, as a result of theresilient configuration of longitudinal sections 232, 234 of movableelectrode 230, is biased to slidably receive a portion of plank 210 soas to guide translation of movable electrode 230 relative to plank 210as end effector assembly 200 is moved from the retracted position to theextended position. In the extended position of end effector assembly200, spacer 238 is positioned distally of plank 210, allowing movableelectrode 230 to resiliently return, under bias, towards its at-restposition, wherein the distal portions of longitudinal sections 232, 234extend above plank 210 and at least portion of U-shaped loop section 236extends above plank 210. Spacer 238 is further configured toelectrically-isolate movable electrode 230 from plank 210 and may beformed at least partially from an insulative material to achieve thispurpose.

In addition or as an alternative to having resilient longitudinalsections 232, 234 that enable transverse movement of movable electrode230 as end effector assembly 200 is moved from the retracted position tothe extended position, movable electrode 230 may be associated with alever or ramp to enable or facilitate transverse movement thereof uponmovement of end effector assembly 200 from the retracted position to theextended position.

Continuing with reference to FIGS. 5A-7, carrier assembly 240 isdisposed between shaft 220 and plank 210 and is engaged with shaft 220at a position proximally-spaced from the distal end of shaft 220.Carrier assembly 240 includes a base 242 that receives the proximal endsof longitudinal sections 232, 234 of movable electrode 230 in fixedengagement therewith. More specifically, the proximal ends oflongitudinal sections 232, 234 of movable electrode 230 are engaged withbase 242 of carrier assembly 240 such that, in their at-rest position,longitudinal sections 232, 234 are angled upwardly towards plank 210.Base 242 is positioned relative to shaft 220 such that spacer 238 andU-shaped loop section 236 of movable electrode 230 are distally-spacedfrom the distal end of shaft 220.

As detailed above, carrier assembly 240 is engaged with shaft 220, theproximal ends of longitudinal sections 232, 234 of movable electrode 230are engaged with carrier assembly 240, and plank 210 is fixed relativeto housing 100. As such, translation of shaft 220 relative to housing100 effects translation of shaft 220, carrier assembly 240, and movableelectrode 230 relative to sheath assembly 300 and plank 210. Inparticular, with reference to FIGS. 5A-5C, in the retracted position ofend effector assembly 200, shaft 220 is disposed in its proximalposition within or protruding a small distance from sheath assembly 300,movable electrode 230 and carrier assembly 240 are disposed withinsheath assembly 300, and the fixed plank 210 extends distally fromsheath assembly 300. As a result of this configuration, in the retractedposition of end effector assembly 200, spacer 238 is disposed betweenplank 210 and movable electrode 230 to urge movable electrode 230 awayfrom plank 210 and towards shaft 220, against the resilient bias ofmovable electrode 230. In this position, movable electrode 230 ispositioned such that U-shaped loop section 236 of movable electrode 230is aligned with U-shaped shaft 220. As mentioned above, U-shaped loopsection 236 of movable electrode 230 is distally-spaced from the distalend of shaft 220. Thus, in the retracted position of end effectorassembly 200, an area “A” having a U-shaped cross-sectionalconfiguration extending distally from shaft 220 through U-shaped loopsection 236 and within the peripheral boundaries defined by U-shapedloop section 236 and shaft 220 is defined. Area “A” is at leastpartially contiguous with channel 224 of shaft 220.

With additional reference to FIGS. 6A-7, during movement of end effectorassembly 200 from the retracted position towards the extended position,shaft 220 is extended distally or further distally from sheath assembly300, and carrier assembly 240 and movable electrode 230 are likewisemoved distally relative to plank 210 and sheath assembly 300. Morespecifically, during movement of end effector assembly 200 from theretracted position to the extended position, spacer 238 of movableelectrode 230 is slid distally along plank 210, with a portion of plank210 received within cut-out 239 of spacer 238. Upon reaching the distalend of plank 210, spacer 238 is urged upwardly to follow rounded lip 218of plank 210 under the resilient bias of movable electrode 230. As endeffector assembly 200 reaches the extended position, spacer 238 clearsthe distal end of plank 210, thereby allowing movable electrode 230 tofully return to its at-rest position under the resilient bias thereof.As movable electrode 230 returns to the at-rest position, U-shaped loopsection 236 of movable electrode 230 is moved upwardly to at leastpartially traverse the area “A.”

Referring to FIGS. 6A-7, in the extended position of shaft 220, spacer238 is spaced distally from plank 210 and movable electrode 230 isdisposed in its at-rest position, wherein the distal portions oflongitudinal sections 232, 234 extend above plank 210 and at leastportion of U-shaped loop section 236 extends above plank 210. Upon shaft220 reaching the extended position, U-shaped loop section 236 of movableelectrode 230 has fully traversed the lumen extending from channel 224of shaft 220.

With reference again to FIGS. 1 and 4, resectoscope 10, as noted above,includes a cable assembly 400 having an outer jacket 410 that encloses apower line 420, energy lines 430, and illumination/video connectionlines 440. Power line 420, more specifically, is coupled to motor 122within housing 100 and extends from housing 100 through outer jacket 410of cable assembly 400. The free end of power line 420 culminates in anelectrical plug (not shown) or other suitable connector to enablecoupling of power line 420 to a source of power, e.g., a standard outletor a generator, for powering motor 122. However, resectoscope 10 mayalternatively be configured as a battery-powered device, e.g., wherein abattery (not shown) disposed within or attached to housing 100 isconfigured to power motor 122.

Energy lines 430 are configured to connect end effector assembly 200 toan energy source for providing electrosurgical energy thereto. Energylines 430 extend distally into housing 100 to connect with end effectorassembly 200 and proximally from housing 100 through outer jacket 410 ofcable assembly 400, ultimately culminating in one or more plugs (notshown) adapted to connect to a source of electrosurgical energy, e.g.,an electrosurgical generator. More specifically, positive and negativeenergy lines 430 are configured to provide first and second potentialsto plank 210 (the fixed electrode) and movable electrode 230,respectively, of end effector assembly 200, thus enabling the conductionof energy through tissue disposed between plank 210 and movableelectrode 230. This conduction of energy through tissue, along with themovement of movable electrode 230 through tissue, as detailed below,facilitates the resection of tissue, as detailed below.

Illumination/video connection lines 440 extend distally through housing100 and within or along end effector assembly 200. More specifically,one or more first illumination/video connection lines 440 couples to LEDassembly 216 (FIG. 7) to enable illumination of the field of view ofendoscope 250, while one or more second illumination/video connectionlines 440 couples to endoscope 250 for powering and controllingendoscope 250, and for relaying video and/or still image signalsobtained by endoscope 250 to an external display (not shown).Illumination/video connection lines 440 extend proximally from housing100 through outer jacket 410 of cable assembly 400, ultimatelyculminating in one or more connectors (not shown) adapted to connect toa suitable external display. Alternatively, endoscope 250 may beconfigured to wirelessly transmit video and/or still image signals to anexternal display.

Continuing with reference to FIGS. 1 and 4, resectoscope 10 may includeone or more actuators (not shown) disposed on housing 100 and configuredto actuate, initiate, and/or control the various features ofresectoscope 10. For example, as noted above, an actuator may be mountedon the exterior of housing 100 and coupled to motor 122 to enableselective activation of motor 122 to drive shaft 220 between theproximal and distal positions. Energization of plank 210 (the fixedelectrode) and movable electrode 230 may be selectively accomplished viaactuation of a separate actuator disposed on housing 100 or remotetherefrom, e.g., via a footswitch or a control on the interface of theelectrosurgical energy source. Alternatively, the actuator foractivating motor 122 may also initiate the supply of energy to plank 210(the fixed electrode) and movable electrode 230. In some embodiments,energy is supplied to plank 210 (the fixed electrode) and movableelectrode 230 only when shaft 220 is translating from the proximalposition to the distal position. With regard to endoscope 250 and LEDassembly 216 (FIG. 7), separate and/or combined actuators may beprovided on housing 100 or remote therefrom for controlling the variousfunctions thereof.

Turning to FIGS. 5A-7, the assembly, use, and operation of resectoscope10 is detailed. With additional reference to FIGS. 2 and 3, sheathassembly 300 is initially engaged with housing 100. To engage sheathassembly 300 with housing 100, sheath assembly 300 is slid proximallyabout end effector assembly 200 until proximal base 310 approximates thedistal end of housing 100. More specifically, proximal base 310 ofsheath assembly is positioned such that L-shaped slots 314 of proximalbase 310 receive posts 114 of housing 100. Once this position has beenachieved, sheath assembly 300 is rotated relative to housing 100 tocouple sheath assembly 300 with housing 100 via a bayonet-styleengagement. With sheath assembly 300 engaged to housing 100, or priorthereto, the distal end of a fluid line (not shown) may be frictionallyengaged about port 332, thus enabling irrigation and/or aspirationwithin sheath assembly 300 and about shaft 220 during the resectionprocedure. A suction input (not shown) may additionally or alternativelybe coupled to the proximal end of shaft 220 to enable suctioning offluids and/or resected tissue through channel 224 of shaft 220.

Referring again to FIGS. 5A-7, in use, with end effector assembly 200disposed in the retracted position (FIGS. 5A-5C), resectoscope 10 isinserted into a surgical site such that the exposed distal portion 212of plank 210 extends over the tissue to be resected. During theinsertion, manipulation, and positioning of resectoscope 10, endoscope250 and/or LED assembly 216 (FIG. 7) may be activated to facilitatevisualization within the surgical site.

Once resectoscope 10 is positioned as desired, motor 122 is activatedand end effector assembly 200 is energized, e.g., plank 210 is energizedto a first potential and movable electrode 230 is energized to a second,different potential. Upon activation of motor 122, shaft 220 is urgedfrom its proximal position to its distal position, wherein shaft extendsdistally or further distally from elongated tubular sheath 320. As shaft220 is advanced distally, movable electrode 230 is likewise moveddistally. During the initial distal movement of movable electrode 230,U-shaped loop section 236 is maintained in alignment with shaft 220 and,thus, does not traverse the area “A.” With energy being conductedbetween U-shaped loop section 236 of movable electrode 230 and plank210, this initial distal advancement of U-shaped loop section 236 cutsthrough tissue along the periphery of area “A,” in a longitudinaldirection, thereby partially separating the tissue disposed within area“A” from the tissue surrounding area “A.”

Upon reaching the extended position of end effector assembly 200, asnoted above, movable electrode 230 is resiliently urged upwardly suchthat U-shaped loop section 236 of movable electrode 230 at leastpartially traverses area “A,” thereby cutting through tissue in atransverse direction, fully separating the tissue disposed within area“A” from surrounding tissue. If suction is applied during the movementof end effector assembly 200 from the retracted position to the extendedposition, the fully separated tissue, which defines a peripheraldimension that approximates the dimensions of channel 224, can be drawninto channel 224 of shaft 220 via the suction to withdraw the resectedtissue from the surgical site.

During the above-detailed resection process, endoscope 250 and/or LEDassembly 216 (FIG. 7) may be activated to enable visualization and,thus, help ensure that the appropriate tissue is resected. As notedabove, the positioning of endoscope 250 is such that the area of viewthereof coincides at least partially with the area “A” and surroundingareas, thus allowing for visualization of tissue being cut and/or tissuethat is about to be cut.

In order to resect additional tissue, end effector assembly 200 may bereturned to the retracted position and the above-detailed resectionprocess repeated.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Such systems employ various robotic elements to assistthe surgeon and allow remote operation (or partial remote operation) ofsurgical instrumentation. Various robotic arms, gears, cams, pulleys,electric and mechanical motors, etc. may be employed for this purposeand may be designed with a robotic surgical system to assist the surgeonduring the course of an operation or treatment. Such robotic systems mayinclude remotely steerable systems, automatically flexible surgicalsystems, remotely flexible surgical systems, remotely articulatingsurgical systems, wireless surgical systems, modular or selectivelyconfigurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

Referring to FIG. 8, a medical work station is shown generally as workstation 1000 and generally may include a plurality of robot arms 1002,1003; a control device 1004; and an operating console 1005 coupled withcontrol device 1004. Operating console 1005 may include a display device1006, which may be set up in particular to display three-dimensionalimages; and manual input devices 1007, 1008, by means of which a person(not shown), for example a surgeon, may be able to telemanipulate robotarms 1002, 1003 in a first operating mode.

Each of the robot arms 1002, 1003 may include a plurality of members,which are connected through joints, and an attaching device 1009, 1011,to which may be attached, for example, a surgical tool “ST” supportingan end effector 1100, in accordance with any one of several embodimentsdisclosed herein, as will be described in greater detail below.

Robot arms 1002, 1003 may be driven by electric drives (not shown) thatare connected to control device 1004. Control device 1004 (e.g., acomputer) may be set up to activate the drives, in particular by meansof a computer program, in such a way that robot arms 1002, 1003, theirattaching devices 1009, 1011 and thus the surgical tool (including endeffector 1100) execute a desired movement according to a movementdefined by means of manual input devices 1007, 1008. Control device 1004may also be set up in such a way that it regulates the movement of robotarms 1002, 1003 and/or of the drives.

Medical work station 1000 may be configured for use on a patient 1013lying on a patient table 1012 to be treated in a minimally invasivemanner by means of end effector 1100. Medical work station 1000 may alsoinclude more than two robot arms 1002, 1003, the additional robot armslikewise being connected to control device 1004 and beingtelemanipulatable by means of operating console 1005. A medicalinstrument or surgical tool (including an end effector 1100) may also beattached to the additional robot arm. Medical work station 1000 mayinclude a database 1014, in particular coupled to with control device1004, in which are stored, for example, pre-operative data frompatient/living being 1013 and/or anatomical atlases.

From the foregoing and with reference to the various figure drawings,those skilled in the art will appreciate that certain modifications canalso be made to the present disclosure without departing from the scopeof the same. While several embodiments of the disclosure have been shownin the drawings, it is not intended that the disclosure be limitedthereto, as it is intended that the disclosure be as broad in scope asthe art will allow and that the specification be read likewise.Therefore, the above description should not be construed as limiting,but merely as exemplifications of particular embodiments. Those skilledin the art will envision other modifications within the scope and spiritof the claims appended hereto.

What is claimed is:
 1. A resectoscope, comprising: an end effectorassembly, including: a fixed electrode adapted to connect to a firstelectrical potential and extending in a longitudinal direction; amovable electrode adapted to connect to a second electrical potential,the movable electrode biased transversely towards the fixed electrode;and a spacer coupled to the movable electrode, wherein the movableelectrode and the spacer are longitudinally movable relative to thefixed electrode between a first position, wherein the spacer is disposedbetween the fixed electrode and the movable electrode so as to maintaina spacing between the movable electrode and the fixed electrode againstthe bias of the movable electrode, and a second position, wherein thespacer is disposed distally of the fixed electrode, allowing the movableelectrode to move transversely towards the fixed electrode under thebias of the movable electrode.
 2. The resectoscope according to claim 1,wherein the movable electrode includes a pair of longitudinal sectionsdisposed within a plane and a U-shaped section, the U-shaped sectioninterconnecting distal ends of the longitudinal sections and extendingtransversely relative to the plane of the longitudinal sections, thelongitudinal sections resiliently biased towards the fixed electrode,thereby biasing the movable electrode transversely towards the fixedelectrode.
 3. The resectoscope according to claim 2, wherein thelongitudinal sections are spaced-apart from one another and disposed oneither side of the fixed electrode, and wherein, in the second positionof the movable electrode and the spacer, the longitudinal sectionsextend transversely beyond the fixed electrode on either side thereof.4. The resectoscope according to claim 1, wherein the end effectorassembly further includes: a longitudinally-extending shaft; and acarrier engaging a proximal end of the movable electrode with thelongitudinally-extending shaft such that movement of thelongitudinally-extending shaft relative to the fixed electrode between aproximal position and a distal position moves the movable electrode andthe spacer between the first and second positions.
 5. The resectoscopeaccording to claim 4, wherein the longitudinally-extending shaft definesa channel having an open distal end, the open distal end of the channelconfigured to receive resected tissue upon movement of the movableelectrode and the spacer from the first position to the second position.6. The resectoscope according to claim 4, wherein the movable electrodeincludes a U-shaped section, wherein, in the first position, theU-shaped section is aligned with the longitudinally-extending shaft, andwherein, in the second position, the movable electrode is offsettransversely relative to the longitudinally-extending shaft.
 7. Theresectoscope according to claim 4, further including: a drive assemblyoperably coupled to the longitudinally-extending shaft; and a motorcoupled to the drive assembly, the motor configured to drive the driveassembly to move the longitudinally-extending shaft between a proximalposition and a distal position.
 8. The resectoscope according to claim7, wherein the drive assembly includes a lead screw defining a helicaltrack and a collar disposed about the lead screw and operably coupled tothe helical track such that rotation of the lead screw translates thecollar about the lead screw, the motor configured to rotate the leadscrew to translate the collar about the lead screw, thereby moving thelongitudinally-extending shaft between the proximal position and thedistal position.
 9. The resectoscope according to claim 8, wherein thehelical track is continuous and wherein the motor is configured to driverotation of the lead screw in a single direction to translate the collarabout the lead screw from a proximal end of the lead screw to a distalend of the lead screw and back to the proximal end of the lead screw.10. The resectoscope according to claim 1, further including: anendoscope disposed on the fixed electrode and defining a field of view;and an illumination assembly disposed on the fixed electrode andconfigured to illuminate the field of view of the endoscope.
 11. Aresectoscope, comprising: a housing; a drive assembly disposed withinthe housing; a motor disposed within the housing and configured to drivethe drive assembly; a shaft coupled to the drive assembly, extendingdistally from the housing, and configured such that when the driveassembly is driven, the shaft translates relative to the housing betweena proximal position and a distal position; a fixed electrode adapted toconnect to a first electrical potential, the fixed electrode fixedrelative to the housing and extending distally from the housingalongside the shaft; and a movable electrode adapted to connect to asecond electrical potential, the movable electrode coupled to the shaftsuch that translation of the shaft relative to the housing between theproximal position and the distal position moves the movable electroderelative to the fixed electrode between a first position and a secondposition.
 12. The resectoscope according to claim 11, wherein the driveassembly includes a lead screw defining a helical track and a collardisposed about the lead screw and operably coupled to the helical tracksuch that rotation of the lead screw translates the collar about thelead screw, the motor coupled to the lead screw and configured to driverotation of the lead screw, and the shaft coupled to the collar suchthat translation of the collar about the lead screw translates the shaftrelative to the housing between the proximal position and the distalposition.
 13. The resectoscope according to claim 12, wherein thehelical track is continuous and wherein the motor is configured to driverotation of the lead screw in a single direction to translate the collarabout the lead screw from a proximal end of the lead screw to a distalend of the lead screw and back to the proximal end of the lead screw.14. The resectoscope according to claim 11, further including a sheathassembly, the sheath assembly including a proximal base releasablyengagable with the housing and an elongated sheath configured to atleast partially surround the shaft, movable electrode, and fixedelectrode.
 15. The resectoscope according to claim 14, wherein theproximal base of the sheath assembly includes a port adapted to connectto at least one of a source of suction or a source of irrigation forapplying suction or irrigation, respectively, through the elongatedsheath.
 16. The resectoscope according to claim 11, wherein the movableelectrode is movable longitudinally along the fixed electrode from thefirst position to an intermediate position and wherein the movableelectrode is movable both longitudinally and transversely relative tothe fixed electrode from the intermediate position to the secondposition.
 17. The resectoscope according to claim 16, wherein themovable electrode is stationary relative to the shaft during movement ofthe movable electrode from the first position to the intermediateposition and wherein the movable electrode is movable transverselyrelative to the shaft during movement of the movable electrode from theintermediate position to the second position.
 18. The resectoscopeaccording to claim 11, further including an endoscope defining a fieldof view that extends at least partially between the fixed electrode andthe shaft.
 19. The resectoscope according to claim 11, wherein themovable electrode includes a pair of longitudinal sections disposedwithin a plane and a U-shaped section, the U-shaped sectioninterconnecting distal ends of the longitudinal sections and extendingtransversely relative to the plane of the longitudinal sections.
 20. Theresectoscope according to claim 19, wherein, in the first position ofthe movable electrode, the U-shaped section is aligned with the shaft,and wherein, in the second position of the movable electrode, theU-shaped section is offset transversely relative to the shaft.